Abstract
Background
Frequency of primary total hip (THA) and total knee (TKA) arthroplasty procedures is increasing, with a subsequent rise in revision procedures. This study aims to describe timing and excess surgical mortality associated with revision THA and TKA compared to those on the waiting list.
Methods
All patients from 2003–2013 in a single institution who underwent revision THA and TKA, or added to the waiting list for the same procedure were recorded. Mortality rates were calculated at cutoffs of 30- and 90-days post-operation or addition to the waiting list.
Results
561 and 547 patients were available for the survivorship analysis in the revision THA and TKA groups respectively. Following exclusion, 901 and 832 patients were available for the 30-day analysis and 484 and 568 patients for the 90-day analysis in the revision THA and revision TKA waiting list groups respectively. The 30- and 90-day mortality rate was significantly greater for the revision THA group compared to the waiting list group (excess surgical mortality of 0.357%, 95% confidence interval 0.098% to 0.866%; p=0.037) (odds ratio of 5.22, 95% confidence interval 0.626 to 43.524; excess surgical mortality of 0.863%, 95% confidence interval 0.455% to 1.153%; p=0.045). The 30- and 90-day mortality rate was not significantly greater for the revision TKA group compared to the waiting list group (excess surgical mortality of zero) (excess surgical mortality of 0.366%, 95% confidence interval 0.100% to 0.651%; p=0.075).
Conclusions
Revision THA is associated with a significant excess surgical mortality rate at 30- and 90-days post operation when compared to the waiting list for the same procedure. However, we have been unable to quantify any increased risk after revision TKA. We would encourage other authors with access to larger samples to use our method to quantify excess mortality after revision TKA.
Level of Evidence
III-Retrospective Cohort Study.
